INTRODUCTION: In this study, we aimed to evaluate the clinical, laboratory, and radiological features of patients with acute appendicitis who underwent antibiotic or surgical treatment and to analyze the efficacy of the nonoperative treatment. METHODS: This study included 205 patients who were treated at the pediatric surgery clinic. Age, gender, time from symptom onset to diagnosis, physical examination parameters, white blood cell count, appendix diameter, fecalith frequency, intra-abdominal free fluid, type of appendicitis, surgery, antibiotic treatment, treatment efficacy, recurrence, complications, length of hospital stay and follow-up period were evaluated for all patients.RESULTS: Of the 205 studied patients, 120 (58.5%) received antibiotic treatment and 85 (41.5%) underwent surgical treatment in the initial treatment. The time from symptom onset to diagnosis, findings of diffuse peritoneal irritation based on physical examination parameters, frequencies of fecalith and intra-abdominal free fluid, and appendix diameter were significantly greater in the group that underwent surgical treatment compared with the group that received antibiotic treatment. Of the 120 patients who underwent antibiotic treatment in the initial treatment, 108 (90%) had successful treatment outcomes. Appendix diameter, fecalith occurrence, white blood cell count and blood glucose level measured after treatment initiation were greater in the patients with failed antibiotic treatment. DISCUSSION AND CONCLUSION: Antibiotic treatment is highly effective for the treatment of patients with uncomplicated acute appendicitis. The treatment should be dynamic and should be based on the clinical, laboratory, and radiological features of the patient and progress of appendicitis.